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Difficulty: MediumBasic Care and Comfort

A nurse is caring for a client who underwent a right transfemoral (above-the-knee) amputation 24 hours ago. Which positioning strategy should be incorporated into the daily routine to ensure optimal joint mobility for future prosthesis use?

  1. Place the client on their abdomen for 30 minutes, three to four times a day.Answer
  2. B
    Support the residual limb on stacked cushions continuously to reduce swelling.
  3. C
    Situate the client in a fully upright seated posture while they remain in bed.
  4. D
    Task the nursing assistant with evaluating the surgical site's healing progress during morning care.

Answer

Place the client on their abdomen for 30 minutes, three to four times a day.
Placing the client in a prone position for short periods several times a day physically extends the hip joint. This action stretches the flexor muscles, preventing the development of a hip flexion contracture, which is critical for future ambulation with a prosthesis.

Step-by-Step Solution

1
Identify the primary long-term mobility goal for a client with a transfemoral amputation.
The goal is successful fitting and ambulation with a lower extremity prosthesis.
Understanding the desired outcome dictates which physical complications must be prioritized and prevented.
2
Determine the anatomical risks associated with a transfemoral amputation.
The client is at high risk for developing hip flexion contractures due to muscle imbalance and prolonged sitting.
Without the weight of the lower leg to naturally extend the hip, the flexor muscles tend to tighten and shorten.
3
Select the nursing intervention that directly counteracts hip flexion.
Prone positioning (lying on the abdomen) physically extends the hip joint.
Routine prone positioning stretches the hip flexors, preserving the range of motion required to properly align and use a prosthetic leg.

Key Concept

Post-Amputation Positioning and Contracture Prevention
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Topics

Basic Care and Comfort

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